Mental Health First Aid Registration
Name
*
First Name
Last Name
Email address
*
example@example.com- This will be the email address used for correspondence about the course.
Contact number
Mobile number 0000 000 000
Phone Number
-
Area Code
Phone Number
Are you a selectability staff member?
Yes
No
Please select the training dates and location you are registering for:
Thursday 9th October and Friday 10th October (TOWNSVILLE)
I would like to book for a group of 10 or more
Organisation Booking
Please note, if a session is not in the list above, it is because the class is full. Email training@selectability.com.au if you'd like to be placed on a waitlist for a MHFA session near you.
Don't forget to specify where you're registering your interest from.
Please note, if a session is not in the list above, it is because the class is full or a session is still being scheduled. Let us know if you'd like to be placed on a waitlist for an upcoming MHFA session near you.
Yes, please add me to the waitlist
No, I will register again another time
Other
What location are you registering your interest for?
Townsville
Mackay
Ingham
Burdekin
Bowen
Charters Towers
Other
Are you booking as an individual or for a group?
Individual
Group
If group, please list ALL people you are booking for below
If group, please list ALL people & their email addresses of which you are booking for below:
Please send the group invoice to the following email:
Information
Please let us know any relevant information that can assist us for delivering the course
Submit
Should be Empty: